The US Department of Health and Human Services escalates its review of hospitals providing gender-related treatments to minors, focusing on billing practices and potential legal violations following a new federal report and ongoing investigations.
The Department of Health and Human Services has escalated its scrutiny of hospitals and clinics that provided gender-related treatment to minors, after a new federal report said insurance billing patterns and financial incentives around the care warranted closer review.
HHS on Thursday released “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of “Gender Medicine.”” The commissioned report examines the growth of paediatric gender programmes across the United States, insurance claims tied to puberty blockers and the financial structures behind what the agency describes as sex-rejecting procedures for children.
According to HHS, more than 225 hospitals and health systems created paediatric gender programmes nationwide. The report reviewed insurance claims from 2015 to 2025 and found about $50 million in puberty blocker claims billed under E34.9, a code used for an unspecified endocrine disorder. It also identified nearly $11 million in claims for patients aged 13 to 17 billed under a diagnosis code for precocious puberty. HHS said the figures do not prove wrongdoing, but argued the billing patterns deserve further examination to determine whether the coding matched the treatment actually delivered.
The report has now fed directly into a wider federal response. HHS says Vice President JD Vance, who chairs the White House Task Force to Eliminate Fraud, and HHS Secretary Robert F. Kennedy Jr. have referred the hospitals and clinics named in the report to the Justice Department and the HHS Office of Inspector General for review of possible legal violations. Kennedy said doctors and hospitals should place children’s health ahead of ideology and money, while CMS Administrator Mehmet Oz said the government has a duty to follow the facts when billing practices obscure the care that was provided.
The latest move adds a financial and legal layer to an already volatile policy fight. In May 2025, CMS launched an oversight programme aimed at hospitals performing paediatric sex-trait modification procedures, asking for information on informed consent, clinical guidance, adverse outcomes and finances. By December 2025, HHS had proposed regulatory action to bar hospitals from carrying out such procedures on children under 18 as a condition of participating in Medicare and Medicaid, with Kennedy saying the treatments did not meet recognised healthcare standards. According to reporting from Becker’s Hospital Review in April 2026, the legal landscape remained unsettled, with more than 20 hospitals pausing or scaling back services amid overlapping investigations and court disputes.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
